Herpangina

What is herpangina?

Herpangina is a viral infection of the back of the mouth.

The main symptoms include:

• sore throat and pain with swallowing
• fever for 2 to 3 days
• small ulcers (2 to 3 mm) surrounded by a red ring on the roof of the mouth and near the tonsils. There are no ulcers in the front of the mouth or on the gums. The average child has 5 of these ulcers, though there can be more.

What is the cause?

Herpangina is caused by several Coxsackie A viruses. A person can have herpangina up to 5 times.

How long does it last?

The sore throat and ulcers usually last 5 to 7 days.

How can I take care of my child?

• Throat pain relief: Children over age 1 can sip warm chicken broth or apple juice. Children over age 4 can suck on hard candy (butterscotch seems to be a soothing flavor) or lollipops. Children over age 6 can gargle with warm water containing a little table salt or antacid solution.
• Diet: Offer a soft, bland diet to reduce the pain. Cold drinks and milkshakes are especially good. Avoid giving your child salty foods, citrus fruits, and foods that need much chewing. Encourage your child to drink favorite fluids to prevent dehydration. For very young children, give fluids by cup rather than from a bottle because the nipple can increase the pain.
• Fever and pain relief: Give your child acetaminophen (Tylenol) or ibuprofen (Advil) for the sore throat or for a fever over 102°F (39°C).
• Common mistakes to avoid: Avoid expensive throat sprays or throat lozenges. Not only are they no more effective than hard candy, but many also contain an ingredient (benzocaine) that may cause an allergic reaction. Antibiotics will not help a viral infection.

When should I call my child's health care provider?

Call during office hours if:

• the pain becomes severe
• your child can't drink enough fluids
• the ulcers last longer than 10 days
• you feel your child is getting worse.